Eficacia clínica y microbiológica de cuatro modalidades de tratamiento periodontal no-quirúrgicoestudio piloto

Abstract

Aim: To develop an optimal full-mouth debridement protocol to be tested and compared with che conventional mechanical scaling and root planing procedure for the assessment of both clinical and microbiological outcomes. Patients and methods: 20 patients with moderare chronic periodontitis were randomized in 4 treatment groups: scaling with curettes during 4 weeks; and debridement in 24 hours, either with curettes; ultrasonic debridement with water irrigation; and ultrasonic debridement with chlorhexidine irrigation. The clinical and microbiological evaluation was done at baseline, and 1, 3 anel 6 months after treatment. The Kruskall-Wallis test was used to detect differences between the treatment groups. Differences within the groups were tested by the signedl rank test. Results: The mean probing pocket depth (PPD) was reduced in all treatment groups after 1, 3 y 6 months. For inicial moderate pockets, PPD reduction in the 24-h groups (1,5-1,8 mm) was higher than in the 4-w group (1,2 mm). These differences were not statistically significant. CAL gain was for observed in all groups, ranging from 0,1-0,8 mm. All the 24-h groups demonstrated better results, although not statisticallty significant, than the 4-w group. Total microbial counts were reduced in all groups after treatment. The frequency of detection of P. gingivalis, P. intermedia, C. rectus, M. micros and F. nucleatum remained rather stable. Conclusion: The different methods of subgingival debridement tested did not demonstrate significant differences in both clinical and microbiological outcomes, although better clinical outcomes were observed in the groups where debridement was rendered in 24 h.